All posts by CHOC Children's

CHOC, University Lab Partners establish unique training program for the next generation of biotech innovators

The CHOC Children’s Research Institute and University Lab Partners (ULP) have jointly developed a new science, technology, engineering, and mathematics (STEM), medical innovation and entrepreneurship program geared toward inspiring Orange County high school students to become the next generation of biotech innovators. 

Through the Medical Innovation and Entrepreneurship program, students will work alongside Orange County’s top leaders in innovation and medicine to gain a real-world view of the multidisciplinary skills needed to thrive in the biotech entrepreneurial world.

The program takes students on a journey from idea to innovation, while gaining the understanding of what is required to implement their vision. Student teams will work with industry mentors to solve real-world unmet clinical needs presented by CHOC clinicians, devising a proof-of-concept, an IP and patent strategy, and exit plan that they will pitch to industry leaders on the final day.

Through pediatric-focused case studies, customized lesson plans, team project work, and mentor opportunities, students will identify real-world solutions to issues that directly impact pediatric patients. Students will learn the role a clinician and engineer play as they navigate unmet clinical needs, hospital systems, care providers, and regulatory trends required for healthcare innovation.

In addition, The Young Entrepreneur OC will foster the next generation of leaders through the transformative experience of building a startup. While teaching the skills to build and lead a company, the program also coaches young people to identify and leverage successful pathways to reach personal and professional goals.

“The CHOC Research Institute is thrilled for the opportunity to help inspire the next generation of leaders in healthcare innovation, potentially laying the groundwork for great strides in translational science, medical device development, and basic science research,”  said Dr. Terence Sanger, CHOC’s vice president of research and chief scientific officer.

During the two-week program delivered through the North Orange County ROP, 60  students from five different school districts will learn the business of medtech and biotech through 50 hours of instruction, 10 hours of dedicated mentorship, and 20 hours of clinical needs assessments, project proposals/presentations, literature reviews, and intellectual property challenges. Students will earn 2.5  UC-transferable credits for their participation.

“By connecting our most precious commodity, our students, to businesses who will invest in them, this partnership benefits us all,” said Dr. Terri Giamarino, superintendent of NOCROP. “We want our students to remain in Orange County and be a part of our growth and sustainability.”

Said Dr. George Tolomiczenko, director of medical innovations at University of California, Irvine: “Clinical needs can take many forms in a healthcare setting. Success in meeting an unmet need relies on understanding the target disease, its underlying etiologies and subgroups. I’m looking forward to teaching these high school students how to refine an unmet clinical need.”

The Medical Innovation and Entrepreneurship High School work-based learning program is one of many projects that will launch from the partnership between the CHOC Research Institute and University Lab Partners. The effort brings together clinical skills, business development skills, hospital management, technology strategy, product ideation, and technology development to help support the larger Orange County biotech and medtech community.

“This partnership is a powerful collaboration that will help generate the energy needed to transform the healthcare industry through leading technology products and platforms. This immersive program transforms career exploration and discovery for Orange County students interested in pursuing an exciting career in innovation” said Karin Koch, ULP’s ecosystem director. 

Learn more about the CHOC Children’s Research Institute.

CHOC makes advancements for neurogenic bladder patients

The Urology Center at CHOC Children’s has implemented and evaluated a bladder pressure and volume diary for patients at risk for increased intravesical pressures.

“Patients dependent on clean intermittent catheterization used ruler-based manometry to measure intravesical pressures before leakage or scheduled drainage at home,” said Dr. Antoine Khoury, chief of pediatric urology. Patients were asked to record measurements while relaxed in a supine position.

Dr. Antoine Khoury, chief of pediatric urology at CHOC Children's
Dr. Antoine Khoury, chief of pediatric urology at CHOC Children’s

Study results

The study included 30 patients ranging in age from 1 to 20, with a mean age of 10.

“Home pressures measured at maximal clean intermittent catheterization volume and mean bladder pressure/volume diary pressures were most reliable in predicting urodynamic pressures greater than 30 cm water (AUC 0.93 and 0.87, respectively). Home pressures measured at maximal clean intermittent catheterization volumes less than 20 cm water were associated with normal bladder pressures (less than 30 cm water) on urodynamics, with a sensitivity of 100% and a specificity of 80%,” said Dr. Khoury.

To view this study in greater detail, click here.

A bladder pressure/volume diary helps patients monitor pressure at home and reduces the need for frequent video urodynamics (VUDS) or urodynamics (UDS). As a complementary tool to urodynamics, it provides early detection for high bladder pressures that have the potential to cause kidney damage and renal failure.

Our care and commitment to children has been recognized

CHOC Children’s Hospital was named one of the nation’s best children’s hospitals by U.S. News & World Report in its 2020-21 Best Children’s Hospitals rankings and ranked in the urology specialty.

Best Children's Hospitals, U.S. News & World Report, Urology, 2020-21

Learn how CHOC’s urology care, ongoing treatment and surgical interventions preserve childhood for children in Orange County, Calif., and beyond

CHOC pioneers medical home for children with autism

The nationwide prevalence of autism spectrum disorder (ASD) in children is one in 54. Finding the most appropriate care for children with ASD, as well as support and education for their families, can be a challenge — a challenge the Thompson Autism Center at CHOC Children’s seeks to make easier.

Thompson Autism Center: Filling the service gap

The Thompson Autism Center is committed to addressing autism defined core symptoms related to social interaction, repetitive behavior and communication via a medical home approach to reduce unmet healthcare needs.

“While our focus is on early diagnosis of ASDs between the ages of 1 and 6, we are also offering many services for the large percentage of children who have co-occurring medical and mental health disorders associated with autism,” said Dr. J. Thomas Megerian, pediatric neurologist and medical director of the Thompson Autism Center.

Dr. J. Thomas Megerian, pediatric neurologist and medical director of the Thompson Autism Center, examines a patient using a stethoscope
Dr. J. Thomas Megerian, pediatric neurologist and medical director of the Thompson Autism Center (left)

“The center is a place for families to come for most of the specialty care needs for their child. Our goal is to have all of the professionals who care for the child communicate with each other in creating a coordinated treatment plan all in one setting, answering questions that families have about their child’s diagnosis and helping to troubleshoot when they are not receiving needed services. We also have specialists who can partner with our families and their school programs to optimize intervention and educational programming and identify appropriate community resources specific to the needs of the child and their family.”

Medical home three-pronged approach

The multidisciplinary Assessment Program offers a comprehensive assessment with a psychologist-led full day evaluation with physicians, speech-language pathologists and occupational therapists as well as a brief confirmatory assessment that’s physician-led, aimed at reducing wait times when a diagnosis is clear.

The Behavior Program addresses refractory behavioral disabilities in a highly structured, safely managed setting to address children and adolescents presenting with agitation, self-injury or aggression. Evidence-based toilet training interventions are also addressed to support each child’s progression. The Behavior Program also offers consultation services for community behavioral therapy providers when a child’s progress stalls despite ongoing therapy.

The Co-Occurring Conditions Program facilitates multidisciplinary consultations, individual or group therapy, and targeting social skill groups to improve interpersonal relationships.

“We also provide transition services and specialists who work on plans for a child’s transition into adulthood,” Dr. Megerian said. “Our mission includes partnering with local organizations, including legal agencies and schools, to provide patients with integration paths into the community.”

Clinical research center of excellence

The Thompson Autism Center is committed to partnering with public and private institutions and government facilities to investigate innovative diagnostics and novel therapies for ASD. Research is ongoing to develop, study and implement behavioral treatments and programs.

“We’re providing a home for groundbreaking research and clinical trials. We’d like to be able to bring clinical trials to the community so that they have safe options for trying novel therapies,” Dr. Megerian said.

Our care and commitment to children has been recognized

CHOC Children’s Hospital was named one of the nation’s best children’s hospitals by U.S. News & World Report in its 2020-21 Best Children’s Hospitals rankings, and ranked in the neurology and neurosurgery specialty.

Best Children's Hospitals, U.S. News & World Report, Neurology & Neurosurgery, 2020-21

Learn how CHOC’s neuroscience expertise, coordinated care, innovative programs and specialized treatments preserve childhood for children in Orange County, Calif., and beyond.

Avoiding burnout: A physician shares self-compassion strategies for provider wellness

By Dr. Rishikesh S. Chavan, pediatric oncologist and medical director of the blood and bone marrow transplant program at the Hyundai Cancer Institute at CHOC Children’s

Navigating the COVID-19 pandemic and a rapidly evolving medical landscape has put added pressure and stress on the healthcare workers braving the front lines. This is why it’s more important than ever to recognize signs of burnout in yourself and your colleagues, and essential that we as physicians practice self-compassion.

As physicians juggle their position as a healthcare provider, possibly the head of their household, and many other roles, it can be almost unnatural for physicians to think of themselves and their own needs.

But as the saying goes, you cannot pour from an empty cup. Physicians can’t do their best to care for patients and their own children at home unless they’re supporting their own comfort. I liken it to the safety instructions on an airplane – put your oxygen mask on before assisting others.

Self-compassion tactics

To avoid self-sabotage or self-destructive tendencies, one needs to feel a deep sense of love and acceptance of themselves. That’s why practicing self-compassion is so important. Here are some ways to get started:    

  • Make your own checklist Similar to a checklist one uses at the end of a shift to transition cases, make a personal one to end or begin your day. Everyone’s checklist will look different. We each classify different habits or rituals as essential. Do you need your morning coffee to function best? If you have exercised are you then your best self? For your checklist, consider elements such as:
    1. Acknowledge something that was difficult during your shift. After the feelings come up, let them go.
    2. Name three things that went well.
    3. Did you notice anyone else have a particularly hard shift? Check on them.
    4. Check in with yourself. Are you OK?
    5. Rest and recharge.
  • Relax – Identify your strategy for relaxation to help you take your mind away from the daily grind. Be aware of self-compassion versus self-indulgence. For example, watching an episode of your favorite TV show is one thing but binge watching an entire season is another. For several people, activities like bike riding, working in the garden, reading a book, practicing a musical instrument, or taking a yoga class may help establish a state of flow and provide an opportunity to go deeper.
  • Meditate – By definition, meditation means to focus on something. As you gently have a subtle focus on your heart, you can be a silent observer of your thoughts without reacting to them. An assumption that you are not your thoughts allows you to ignore intrusive thoughts and achieve a sense of peace. Sitting quietly with a guided meditation via apps such as Heartfulness, Headspace or Calm may help you get started. Studies have shown that peace and tranquility rank among the most common feelings people report after meditating, in whatever modality suits them.
  • Check in with your colleagues –Not only should we check in with ourselves, but we should check on our colleagues as well. If you see signs of burnout in a colleague, gently bring them into a conversation, or bring them a cup of coffee, and ask, “Is everything OK? Is there something that you want to talk about? Can I help you with anything?”

Interventions for physician burnout

A 2017 JAMA study found that the strongest evidence for effectiveness in combating physician burnout was organization-directed interventions, but the study noted such programs were rare. Most interventions for physician burnout put the onus back on the physician, with a focus on incentivizing physicians to participate. More effective intervention models are engrained across an entire hospital or healthcare system.

In January 2018, CHOC convened a Physician Wellness Subcommittee, composed of a group of physicians dedicated to help CHOC continue to be proactive and supportive of physicians. Its mission is “To promote physician wellness to benefit ourselves and others.”

Additionally, at CHOC, the spiritual care team offers regular “Tea for the Soul” sessions where chaplains are available to clinicians and provide a compassionate, non-anxious, non-judgmental presence to help them cope with added stressors.

CHOC leadership has taken other steps to provide additional support for its physicians and staff, recognizing the additional stressors placed upon CHOC staff during COVID-19. CHOC’s on-site daycare was set up within 72 hours, giving clinicians peace of mind that their children are safe and happy while they work. Recognizing that shopping for groceries and sundries might be challenging for staff, CHOC has set up in-house shopping resources, as well as a grab-and-go meal program and farmers market.

What referring providers should know about safety at CHOC during COVID-19

At CHOC Children’s, we know you want to provide your patients the very best care every day, especially during these uncertain times. CHOC has been in close contact with local, state and federal authorities to stay up to date with the latest outbreak information and ensure we’re following the best practices to limit the spread of COVID-19.

For the safety of our patients and families, here are just a few of the following procedures and measures currently in place:

  • Developed workflows to triage patients presenting with possible symptoms and best practices for treating suspected cases.
  • Increased screening at all CHOC entrances. All visitors, patients, physicians and staff members are screened for COVID-19 symptoms.
  • Everyone is required to wear a mask at all CHOC locations. For those who don’t have masks, we will provide our donated cloth masks at screening.
  • Visitor guidelines have been strengthened to help protect our patients, families, physicians and staff. For full details, please see our visitor guidelines.
  • Clinical areas are cleaned multiple times per day, in addition to the medical grade sanitization we have always provided. We will continue to thoroughly sanitize to the most rigorous standards.
  • We have established an Incident Command Center composed of a multidisciplinary team of leaders. The Command Center centralizes operational decisions, and coordinates CHOC’s response with local authorities and neighboring facilities.

As CHOC and other healthcare facilities adapt to the fluid environment created by the COVID-19 pandemic, and national, state and local recommendations and guidelines changing, we want you to know that we are open and have the following resources to help provide the safest care:

Telehealth appointments are available. To refer a patient, please call the Patient Access Center at 888-770-2462.

• Our 24/7 Nurse line, 1-844-GET-CHOC, is available for parents who have questions about their child’s health.

• If your patients’ families have recently lost or do not have medical insurance, they can call CHOC Children’s Family Financial Resource Center at 714-509-8600.

Please visit our website for the latest information about visiting our locations.